Department of Counseling, Clinical, and School Psychology.
Department of Education.
J Consult Clin Psychol. 2020 Jul;88(7):597-612. doi: 10.1037/ccp0000500.
We explored the internal structure of within-group variation in the syndemic construct among bisexual adolescents, an understudied and highly vulnerable population known to experience health disparities compared with monosexuals (those attracted to a single gender). We sought to identify patterns of co-occurrence among three domains of high priority behavioral risks-sexual risk factors, substance use, and victimization-and their implications for suicidality.
We used a national sample of 1,053 ethnically/racially diverse, high school age bisexual adolescents drawn from the 2015 Youth Risk Behavior Surveillance System (YRBSS). We applied latent class analysis (LCA) to 15 indicators measuring the three aforementioned domains and modeled predictors and an outcome of class membership.
Within-group variation in the syndemic construct appears categorical, systematic, and comprised of Low Risk (38%), Alcohol Use (20%), Peer-victimization (14%), Sexually Active (11%), Syndemic (11%), and Risk-taking (7%) classes. Classes were well-separated per classification statistics. The proportions of bisexual identification, sex, and race varied significantly across classes. Syndemic and Peer-victimization classes were equivalent and elevated in their suicidality risk, out of all classes.
Results revealed multiple and diverging forms of conjoint behavioral risk that conferred differential health implications; illuminated the shape and functional form of the syndemic construct among bisexual adolescents; and illustrated the utility of LCA for classifying typologies of risky and normative health behavior patterns. Psychologists are recommended to carefully consider the comorbidly operant nature of behavioral risks in this population. Future directions include addressing replication, multiple-group invariance, additional auxiliary variables, and alternative mixture techniques. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
我们探索了双性恋青少年群体中综合征结构的组内变异的内在结构，该人群是一个研究不足且高度脆弱的群体，与单性恋者（只对单一性别有吸引力的人）相比，他们的健康状况存在差异。我们试图确定三个高优先级行为风险领域（性风险因素、物质使用和受害）的同时出现模式及其对自杀的影响。
我们使用了来自 2015 年青少年风险行为监测系统（YRBSS）的 1053 名具有种族/民族多样性的高中生的全国性双性恋青少年样本。我们应用潜在类别分析（LCA）对 15 个指标进行分析，这些指标衡量了上述三个领域，并对类别成员的预测因素和结果进行建模。
综合征结构的组内变异似乎是分类的、系统的，由低风险（38%）、酒精使用（20%）、同伴受害（14%）、性活跃（11%）、综合征（11%）和冒险（7%）类组成。根据分类统计数据，各个类别之间的区分度较好。双性恋认同、性别和种族的比例在各个类别之间存在显著差异。在所有类别中，综合征和同伴受害类别的自杀风险相当高。
结果揭示了多种不同形式的联合行为风险，这些风险对健康有不同的影响；说明了双性恋青少年综合征结构的形状和功能形式；并说明了潜在类别分析在对风险和正常健康行为模式进行分类方面的实用性。建议心理学家在该人群中仔细考虑行为风险的共发性。未来的方向包括复制、多组不变性、附加辅助变量和替代混合技术。
